Laserfiche WebLink
MONITORING WELL INSTALLATION REPORT <br /> Date: 6 - g- 91 CONSTRUCTION <br /> C, J <br /> Premise Address: 4!t— Total Depth 1b. <br /> b• 5 <br /> Length (from) (to) <br /> Well No.: tj Filter Pack ) <br /> Bentonite (from) (to) <br /> Inspector: SC.G�1�1Lsll � Grout (fro <br /> Drilling rig <br /> Permit No. Auger O. I.D. <br /> /�. Comp on - Stove pipe/christie box (circle one) <br /> Consultant Y�C.�ISL GWI"✓6lsNi w ,Gl°OuP <br /> Geologist SIM (LSP soP <br /> SPECIAL PERMIT INFO. Al;0 RCUND <br /> SSU COW ION I LETIOX <br /> Distance to sewer line LETION <br /> Domestic well on site - n ) �Sut°w <br /> If yes, location and distance - rout <br /> �NtS f.mt71 _ 1SOKL9i GcSlz7� GD2 <br /> SAMPLING e !/j�llj?/ � '� S , /5" Ib •S � z <br /> c <br /> �C doted — 3 <br /> Holding Temperaturg <br /> Method ICK CL �°° = = <br /> Screening Method �� = gm$I <br /> Tracking Sheet - y n) <br /> yy 4 <br /> Il. fL <br /> SPOILS n <br /> Storage Method MATERIALS/DEVELOPMENT <br /> Contamination Notes - n ) <br /> Storage Location 9t.6471— Cas type / <br /> Blank_ ft. Screery ft. <br /> Slot size <br /> Bags cement <br /> GROUTING Buckets bentonite <br /> I Bags sand/gravel _ <br /> Depth to water b Filter Pack type/size <br /> Mix Ratios // �iNt Kid Cfsrr✓I�N� Surge Block: - (y/ ) <br /> Installation Method 712/t k1 ) ffoyK l%i!t M22;l o.4- t9 ALDiscussed with o <br /> in logist: - (y/ n ) <br /> Quantity Installed Type of metho <br />